Department of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, M2 Annex, Cleveland, OH 44114, USA.
Department of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, M2 Annex, Cleveland, OH 44114, USA; Department of Inflammation and Immunity, Cleveland Clinic Lerner College of Medicine, Case Western University, Cleveland, OH 44195, USA.
Clin Liver Dis. 2019 May;23(2):363-382. doi: 10.1016/j.cld.2019.01.001.
Nonalcoholic fatty liver disease (NAFLD), a disorder of altered metabolic pathways, is increasing worldwide. Recent studies established obstructive sleep apnea (OSA) and chronic intermittent hypoxia (CIH) as NAFLD risk factors. Studies have ascertained that CIH is independently related to NAFLD. Continuous positive airway pressure (CPAP) shows inconsistent results regarding its efficacy in improving NAFLD. Observational, longer duration CPAP therapy studies have shown positive outcomes, whereas shorter duration, randomized controlled trials have shown no benefit. A multifaceted approach to NAFLD management with sufficiently longer duration of CPAP therapy may be beneficial in patients with moderate to severe OSA.
非酒精性脂肪性肝病(NAFLD)是一种代谢途径改变的疾病,在全球范围内正在不断增加。最近的研究将阻塞性睡眠呼吸暂停(OSA)和慢性间歇性低氧(CIH)确定为 NAFLD 的危险因素。研究已经确定 CIH 与 NAFLD 独立相关。持续气道正压通气(CPAP)在改善 NAFLD 方面的疗效显示出不一致的结果。观察性、更长时间的 CPAP 治疗研究显示出积极的结果,而较短时间的随机对照试验则没有显示出获益。对于中重度 OSA 患者,采用 CPAP 治疗时间足够长的多方面方法来管理 NAFLD 可能是有益的。